JP2013202075A - Lid and retractor having the same - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a lid and a retractor having the same, capable of securing a wide movable area of a treatment instrument and allowing the treatment instrument to be easily operated.SOLUTION: A lid includes: a top plate with at least one opening; and a frame member formed in the periphery of the top plate to be engaged with an end of a retractor body. The opening is located on the inner side of the end of the retractor body when the lid is attached to the retractor body. A retractor has the lid detachably attached to the tubular retractor body. As the distance from a fulcrum of a treatment instrument to the distal end of the retractor body is short, the treatment instrument in the inclined state can be inserted, and therefore, a wide movable area of the treatment instrument can be secured. Further, as the distance from the fulcrum of the treatment instrument to a treated region is also short, the treatment instrument can be easily operated.

Description

  The present invention relates to a lid and a retractor including the lid.

  In laparoscopic surgery, single-hole surgery is performed in which a plurality of treatment tools such as forceps and optical devices are inserted from a single incision. Single-hole surgery has a high cosmetic merit because there is only one incision remaining on the patient's body surface. In particular, it is common to form an incision in the navel in order to prevent the incision from being noticeable after surgery.

  In recent years, in laparoscopic surgery, a dedicated instrument for putting a plurality of treatment tools into one incision has been developed. Such an instrument includes a cylindrical retractor body that holds an incision wound in an open state, and a lid body that has a plurality of small holes into which treatment instruments are inserted (see Patent Document 1).

JP 2002-28163 A

  However, since the small hole is provided at the same height as the body surface in the instrument of Patent Document 1, from the fulcrum of the treatment tool, that is, the position of the small hole, to the distal end side edge (body inner edge) of the holder main body. The distance is long. For this reason, the treatment instrument cannot be inserted at a large angle, and the movable range of the treatment instrument cannot be widened. Further, since the fulcrum of the treatment tool is far from the treatment part, the operation of the treatment tool may be difficult.

  The present invention has been made in view of the above-described problems, and has a wide movable range of the treatment instrument to be inserted, and a lid that facilitates operation of the treatment instrument because the fulcrum of the treatment instrument is close to the treatment portion. And a retractor comprising the same.

Such an object is achieved by the present invention described in the following (1) to (6).
(1) A lid that is detachably attached to a retractor body having a cylindrical shape, wherein the lid is formed around a top plate portion having at least one opening, and the top plate portion, A frame member that engages with an end portion of the retractor body, and the opening is located inside the end portion of the retractor body when the lid is attached to the retractor body. The lid to do.
(2) The top plate has a portion that is recessed toward the inside of the retractor body when the lid is attached to the retractor body, and the opening is at a bottom of the recessed portion. The lid according to (1), which is formed.
(3) The opening according to (1) or (2), wherein the opening includes an opening forming portion that prevents the shape of the opening from being deformed around the opening.
(4) The lid according to (3), wherein the top plate portion includes a support portion that swingably supports the opening forming portion.
(5) The lid according to (4), wherein the support portion is formed such that at least a part of the top plate portion has a bellows shape.
(6) The lid according to (4), wherein the support portion includes at least a part of the top plate portion made of a softer material than the top plate portion.
(7) A retractor comprising the lid according to any one of (1) to (6) and a retractor body.

  According to the present invention, since the distance from the fulcrum of the treatment instrument to the distal side edge of the retractor body is short, the treatment instrument can be inserted in a more inclined state. Therefore, the movable range of the treatment instrument can be widened. In addition, since the distance from the fulcrum of the treatment tool to the treatment portion is short, the treatment tool can be easily operated.

1 is an overall view of a retractor according to a first embodiment of the present invention. (A) is the figure of the state which isolate | separated the cover body from the retractor main body, (b) is the figure which mounted | wore the retractor main body with the cover body. It is a top view of the lid concerning a first embodiment of the present invention. FIG. 3 is a sectional view taken along line III-III in FIG. 2. It is explanatory drawing of the use condition of a retractor. (A) It is the figure explaining the movable range of the treatment tool at the time of using the retractor which concerns on 1st embodiment of this invention. (B) It is the figure explaining the movable range of the treatment tool at the time of using the conventional retractor. It is explanatory drawing of the use condition of a retractor. (A) It is explanatory drawing at the time of using the retractor which concerns on 1st embodiment of this invention. (B) It is explanatory drawing at the time of using the conventional retractor. It is sectional drawing of the retractor which concerns on 2nd embodiment of this invention.

<First embodiment>
Hereinafter, preferred embodiments of a lid of the present invention and a retractor including the lid will be described in detail with reference to the drawings.
FIG. 1 is an overall view of a retractor according to a first embodiment of the present invention. 2 is a top view of the lid according to the first embodiment of the present invention, and FIG. 3 is a sectional view taken along line III-III in FIG.

  The retractor 1 of the present embodiment is an instrument for assisting various treatments such as observation, washing, excision, instrument placement, and collection within the abdominal cavity while maintaining the incision in the abdomen open.

  As shown in FIG. 1, the retractor 1 of the present embodiment includes a retractor body 2 that has a tubular shape, and a lid 3 that is detachably attached to the retractor body 2.

  The retractor body 2 is a member that is attached to the incision and applies a radial force to the incision to expand it. In the present embodiment, the retractor main body 2 includes a cylindrical member 21 having flexibility, and a first fixing member 22 and a second fixing member 23 provided at both ends of the cylindrical member 21. Further, the retractor body 2 is provided with four belts 24 extending between the two fixing members inside the tubular member 21.

Both the first fixing member 22 and the second fixing member 23 have a flat plate shape. The first fixing member 22 is inserted into the abdominal cavity through the incision and is used in close contact with the back surface of the abdominal wall. The second fixing member 23 is used in close contact with the surface (body surface) of the abdominal wall.
The retractor main body 2 has a cylindrical shape in which a cylindrical member 21 and an annular first fixing member 22 and a second fixing member 23 are coaxially connected. Here, the cylindrical shape may be a cylindrical shape or a rectangular tube shape.

  As shown in FIG. 1A, the front end portion of the belt 24 is fixed to the first fixing member 22. Further, the base end portion of the belt 24 is inserted through the second fixing member 23 from the radial inner side to the outer side. Each of the belt 24 and the second fixing member 23 is provided with a ratchet structure (not shown). The ratchet structure allows sliding when the base end portion of the belt 24 is pulled out radially outward of the second fixing member 23, and conversely restricts sliding in which the base end portion of the belt 24 returns to the inside in the radial direction. . Then, by pulling the proximal end portion of the belt 24 radially outward with respect to the second fixing member 23, the first fixing member 22 is pulled up and the distance from the second fixing member 23 is shortened.

  Here, the first fixing member 22 is inserted into the incision, and the belt 24 is pulled with the first fixing member 22 and the second fixing member 23 holding the abdominal wall loosely. The two fixing members 23 are in close contact with the back and front surfaces of the abdominal wall. As a result, a through hole having both ends of the open ends of the annular first fixing member 22 and the second fixing member 23 is formed inside the incision. The excised tissue is removed through the through hole.

  As the first fixing member 22 and the second fixing member 23, any material can be used as long as it has rigidity enough to fix the retractor 1 to the incision. Examples of such materials include polyolefins such as polyethylene (PE) and polypropylene (PP), polyvinyl chloride, polyurethane (PU), polyamide (PA), polyacetal, acrylonitrile / butadiene / styrene copolymer (ABS), and polycarbonate. Examples thereof include resin materials such as (PC), hydrogenated styrene-based thermoplastic elastomer (SEBS), and silicone rubber, and metal materials such as stainless steel.

  Any material can be used as the cylindrical member 21 as long as it is a soft material. Examples of such materials include polyolefins such as PE and PP, polyesters such as polyethylene terephthalate, resin materials such as PU, PA, soft polyvinyl chloride, SEBS, silicone rubber, and natural rubber.

  Here, typical dimensions of the retractor body 2 will be described. The first fixing member 22 and the second fixing member 23 have an outer diameter of about 40 to 120 mm, an inner diameter of about 30 to 110 mm, and a thickness of about 5 to 20 mm. Moreover, the cylindrical member 21 consists of a film | membrane with a thickness of 0.05-3 mm, and height is about 40-120 mm. The length of the belt 24 is about 50 to 150 mm.

  The lid 3 is detachably attached to the second fixing member 23 of the retractor main body 2 and closes the proximal end side opening (opening on the second fixing member 23 side) of the retractor main body 2 to thereby open the incision. This is an airtight covering member.

  As shown in FIGS. 2 and 3, in the present embodiment, the lid 3 is formed around the top plate portion 32 having two openings (first opening 34 a and second opening 34 b) and the top plate portion 32. The frame member 31 is provided.

  The frame member 31 attaches the lid 3 to the retractor body 2 by engaging with the second fixing member 23 of the retractor body 2. In the present embodiment, the frame member 31 has an annular shape. On the side surface of the frame member 31, four engagement convex portions 311 are provided projecting toward the center of the frame member 31 at equal angular intervals. The engaging convex portion 311 attaches the lid 3 to the retractor body 2 by engaging with the engaging concave portion 231 formed on the peripheral surface of the second fixing means 23.

  Any material can be used for the frame member 31 as long as it has the same degree of rigidity as the first fixing member 22 and the second fixing member 23. Examples of such materials include polyolefins such as polyethylene (PE) and polypropylene (PP), polyvinyl chloride, polyurethane (PU), polyamide (PA), polyacetal, acrylonitrile / butadiene / styrene copolymer (ABS), and polycarbonate. Examples thereof include resin materials such as (PC), hydrogenated styrene-based thermoplastic elastomer (SEBS), and silicone rubber, and metal materials such as stainless steel.

  As shown in FIGS. 1 and 3, the top plate 32 is provided so as to be surrounded by a frame member 31. The top plate portion 32 has a portion that is recessed toward the inside of the retractor body 2 when the lid 3 is attached to the retractor body 2. In the present embodiment, as shown in FIG. 3, the entire top plate portion 31 is recessed. And although the bottom part of the recessed part is parallel to the frame member 31, it is not restricted to parallel, A curved surface shape etc. may be sufficient. The recessed portion is not limited to the entire top plate portion, and may be recessed at least in a portion surrounding the opening formed in the top plate portion 32. When there are a plurality of openings, a plurality of recessed portions are provided for each opening. You may have a part to sink.

  Any material can be used for the top plate portion 32 as long as it has a rigidity that does not greatly displace when the treatment instrument 7 is inserted and removed. Examples of such a material include synthetic rubber such as soft polyvinyl chloride, PU, SEBS, silicone rubber, natural rubber, and nitrile rubber.

  The top plate portion 32 has two openings (a first opening 34a and a second opening 34b). In the present embodiment, the openings 34 a and 34 b have circular shapes of the same size, and are formed at the bottom of the recessed portion of the top plate portion 32. The openings 34a and 34b are mainly used to insert a treatment tool, an optical device, or the like and perform treatment on the treatment portion through the incision.

  In the present embodiment, the top plate portion is recessed, and an opening is formed in the recessed portion.However, the present invention is not limited to this, and when the lid is attached to the retractor body, the retractor body The opening may be formed so as to be located inside the end portion. Further, the number of openings is not limited to two, and may be one or three or more. Furthermore, the shape of the opening is not limited to a circle, and may be a polygon, for example, and the size may be different for each opening.

  In order to prevent the shape of the opening from being deformed around the openings 34a and 34b, an opening forming portion is provided. In the present embodiment, the opening forming portion is a ring-shaped opening holding member (first opening holding member 33a, second opening holding member 33b). That is, the insides of the opening holding members 33a and 33b are the openings 34a and 34b. The opening holding members 33a and 33b hold the shape of the opening and also play a role of supporting the treatment instrument inserted into the openings 34a and 34b.

  The opening holding members 33a and 33b include valve bodies (first valve body 35a and second valve body 35b) on the distal end side. The valve bodies 35a and 35b are provided so as to cover the openings 34a and 34b, respectively, and are closed when the treatment instrument or the like is not inserted, and are opened when the treatment instrument or the like is inserted. In the present embodiment, the valve bodies 35a and 35b have a circular sheet shape, and a cross-shaped slit is provided at the center. The valve body may be of any form as long as it is opened and closed as described above. For example, a duckbill valve or a flap valve may be used. In addition, the attachment position of the valve body is not limited to the distal end side of the opening support member, and may be provided at the proximal end side or the intermediate portion, and provided with a plurality of valve bodies such as being provided at both the distal end portion and the proximal end portion Also good.

  Here, the functions of the openings 34a and 34b in the present embodiment will be described in comparison with the prior art with reference to FIG. FIG. 4 (a) is a diagram illustrating the movable range of the treatment instrument 7 when the retractor 1 according to the first embodiment of the present invention is used, and FIG. 4 (b) uses the conventional retractor 4. It is a figure explaining the movable range of the treatment tool 7 in the case.

  First, the configuration of the conventional retractor 4 will be briefly described. The retractor 4 includes a tubular retractor main body 5 and a lid 6 that is detachably attached to the retractor main body 5 in the same manner as the retractor 1 of the present embodiment. The retractor body 5 includes a flexible cylindrical member 51, a first fixing member 52 and a second fixing member 53 provided at both ends of the cylindrical member 51, a first fixing member 52, and a second fixing member 52. And four belts (not shown) extending between the fixing members 53.

  The lid 6 of the conventional retractor 4 includes a top plate portion 62 having two openings (first opening 63a and second opening 63b) and a periphery of the top plate portion 62 in the same manner as the lid 3 of the present embodiment. And a frame member 61 to be formed. However, the top plate portion 6 of the retractor 4 has a circular flat plate shape, unlike the top plate portion 3 of the present embodiment. Accordingly, the openings 63a and 63b are formed in the same plane as the proximal end side edge (second fixing member 52) of the retractor body 5 when the lid body 6 is attached to the retractor body 5.

  The retractor 1 of the present embodiment and the conventional retractor 4 are instruments for assisting various procedures such as observation, washing, excision, placement and collection of instruments in the abdominal cavity, and these procedures are performed by the openings 34a and 34b. Alternatively, it is performed by inserting a treatment instrument or the like into the openings 63a and 63b. At this time, since the target site of the treatment portion is not necessarily directly below the openings 34a and 34b or the openings 63a and 63b, the treatment tool 7 may be used with an appropriate inclination with respect to the openings 34a and 34b or the openings 63a and 63b. is there.

  When the treatment instrument 7 is tilted, how much the treatment instrument can be tilted differs depending on the tilting direction. In particular, when the treatment instrument 7 is tilted outward, the tilt angle cannot be taken most. In this case, as shown in FIG. 4, the treatment tool 7 can be tilted only until it comes into contact with the second fixing member 23, and the movable range of the treatment tool 7 is limited.

  The first fixing member 22 and the second fixing member 23 of the retractor main body 2 are in close contact with the back surface and the surface of the abdominal wall by pulling the belt 24. Therefore, the distance from the first fixing member 22 to the second fixing member 23 is determined by the thickness of the patient's abdominal wall. Here, as shown in FIG. 4B, in the conventional retractor 4, since the openings 63a and 63b are formed in the same plane as the second fixing member 53, the first fixing member 52 extends from the openings 63a and 63b. The distance to becomes longer. For this reason, in the conventional retractor 4, the treatment tool 7 cannot be tilted so much.

  On the other hand, as shown in FIG. 4A, in the retractor 1 of the present embodiment, the openings 34a and 34b are the ends of the retractor body 2 when the lid is attached to the retractor body (second fixing member 23). It is formed so as to be located on the inner side. Therefore, the distance from the openings 34a and 34b to the first fixing member 22 is shortened, and the treatment instrument 7 can be greatly inclined.

This will be described in more detail. 4A and 4B, the distance from the second fixing members 23 and 53 to the center of the first openings 34a and 63a is a, and the distance from the center of the first opening 34a to the first fixing member 22 is as follows. The shortest distance is b, the shortest distance from the center of the first opening 63a to the first fixing member 52 is c, the maximum inclination angle of the treatment instrument 7 inserted into the first opening 34a is θ _A , and the first opening 63a is inserted. the maximum inclination angle of the treatment instrument 7 and theta _B. At this time, θ _A = arcsin (a / b), θ _B = arcsin (a / c), and b <c to θ _A > θ _B. That is, if the opening is at the same position in plan view, the retractor 1 of the present embodiment can tilt the treatment instrument 7 much more than the conventional retractor 4. Accordingly, the retractor 1 of the present embodiment can widen the movable range of the treatment instrument 7.

  Furthermore, when performing treatment by inserting the treatment tool 7 into the openings 34a and 34b, the treatment tool 7 is operated with the openings 34a and 34b as fulcrums. At this time, since the distance from the openings 34a and 34b to the treatment portion is short in the retractor 1 of the present embodiment, a more delicate operation is possible as compared with the conventional retractor 4.

  As shown in FIGS. 2 and 3, support portions 36 are respectively formed in portions surrounding the first opening holding member 33 a and the second opening holding member 33 b. The support portion 36 is more flexible than the other portions of the top plate portion 32, and supports the opening holding members 33a and 33b in a swingable manner. In the present embodiment, the support portion 36 is formed with the top plate portion 32 having a bellows shape centering on the opening holding members 33a and 33b. In addition, a support part is not restricted to this, For example, you may form using flexible resin compared with the other part of a top-plate part. Examples of the material of the support portion 36 in this case include polyurethane (PU), soft polyvinyl chloride, hydrogenated styrene thermoplastic elastomer (SEBS), synthetic rubber such as silicone rubber, natural rubber, and nitrile rubber. Further, in this embodiment, a part of the periphery of the opening holding members 33a and 33b is used as the support part 36. However, the present invention is not limited to this, and the entire top plate part 32 may be used as the support part 36.

  Here, with reference to FIG. 5, the function of the support part 36 in this embodiment is demonstrated compared with a prior art. FIG. 5A is an explanatory diagram of the usage state of the retractor 1 according to the first embodiment of the present invention, and FIG. 5B is an explanatory diagram of the usage state of the conventional retractor 4.

  As described above, in the treatment via the retractor 1, the treatment instrument 7 may be used while being inclined with respect to the openings 34a and 34b. At this time, if it is the conventional retractor 4, the top-plate part 62 has a certain amount of rigidity and does not deform | transform easily. Accordingly, the treatment instrument 7 can be inclined only by the difference between the inner diameters of the openings 63a and 63b and the outer diameter of the treatment instrument 7 or by a slight deformation amount of the top plate portion 62, and when attempting to incline beyond that, Unnecessary force is applied to the top plate portion 62, which may cause a problem of positional displacement of the treatment instrument 7 described later. For this reason, the treatment tool 7 that can be used is limited by the positional relationship between the openings 63a and 63b and the treatment portion.

  On the other hand, in the retractor 1 of the present embodiment, the flexible holding portion 36 supports the opening holding members 33a and 33b. Therefore, the treatment instrument 7 can be tilted together with the opening holding members 33a and 33b into which the treatment instrument 7 is inserted, and the treatment instrument 7 can be freely tilted and used even if the outer diameter of the treatment instrument 7 is substantially equal to the inner diameter of the openings 34a and 34b. Can do.

  Also, as shown in FIG. 5B, when the treatment is performed by inserting the treatment tools 7a and 7b into the plurality of openings 63a and 63b, in the conventional retractor 4, one treatment tool 7a is inclined. Sometimes, the other treatment instrument 7b follows and the position thereof is shifted. That is, when one treatment instrument 7a is tilted, a portion near the opening 63a into which the treatment instrument 7a is inserted tilts. As a result, tension is applied to a portion in the vicinity of the other opening 63b, and if this portion is also tilted, the treatment instrument 7b inserted therein may be tilted.

  On the other hand, as shown to Fig.5 (a), in the retractor 1 of this embodiment, when the treatment tool 7a is inclined, the part of the opening 34a vicinity in which this is inserted inclines. However, since the tension is attenuated by the support portion 36 formed around the opening 34a (opening holding member 33a), the tension is effectively prevented from reaching the opening 34b (opening holding member 33b). Therefore, in the retractor 1 of this embodiment, even if the treatment instrument 7a inserted into one opening 34a is tilted, there is almost no deviation such as the treatment instrument 7b inserted into the other opening 34b tilting.

  As described above, in the present embodiment, the opening holding members 33a and 33b are supported by the support portion 36 so as to be swingable, so that the opening holding members 33a and 33b can be independently moved. Therefore, the movement of the treatment instrument 7a inserted into one opening holding member 33a hardly affects the treatment instrument 7b inserted into the other opening holding member 33b, and the treatment instrument 7 can be operated freely.

  Here, typical dimensions of the lid 3 will be described. The frame member 31 has an outer diameter slightly larger than that of the second fixing member 23, about 45 to 135 mm, an inner diameter of about 40 to 120 mm, and a thickness of about 5 to 20 mm. The top plate 32 has a thickness of about 0.5 to 5 mm, and the recessed portion has a diameter of about 35 to 115 mm and a depth of about 5 to 35 mm. Further, the openings 34a and 34b have a diameter of about 2 to 15 mm.

  Next, the usage method of the retractor 1 which concerns on this embodiment is demonstrated. The retractor 1 of this embodiment is mainly used for treatment in the abdominal cavity. First, an incision is formed in the abdomen. The incision may be variously formed such as a single letter or a cross. The first fixing member 22 of the retractor body 2 is inserted into the abdominal cavity through this incision. Next, the belt 24 is pulled one by one while the second fixing member 23 is lifted and the first fixing member 22 is brought into close contact with the back surface of the abdominal wall. Accordingly, the incision can be opened larger, and the retractor body 2 is fixedly installed on the incision by sandwiching the abdominal wall between the first fixing member 22 and the second fixing member 23.

  An internal treatment is performed via the retractor body 2. When performing an insufflation operation, the lid 3 is attached. The lid body 3 is mounted by placing the lid body 3 on the second fixing member 23 and rotating the lid body 3 clockwise by about 45 degrees. Thereby, the engagement convex part 311 of the lid 3 and the engagement concave part 231 of the second fixing member 23 are engaged, and the lid 3 is fixed to the retractor body 2. In addition, what is necessary is just to rotate the cover body 3 about 45 degree | times counterclockwise when removing.

  When the treatment inside the body is performed with the lid 3 attached, the treatment is performed through the openings 34a and 34b. Examples of the treatment tool 7 to be used include a grasping forceps, a scalpel knife, an auxiliary forceps, an optical device, and a trocar for inserting them. These treatment tools 7 are inserted into the openings 34a and 34b to perform treatment inside the body.

  At this time, in the retractor 1 of the present embodiment, the top plate portion 32 of the lid 3 has a recessed portion, and the openings 34a and 34b are formed in the recessed portion. In addition, the treatment instrument 7 can be used with a large inclination. Therefore, a wider range of treatments can be performed as compared with the conventional retractor. The treatment instrument 7 is operated using the openings 34a and 34b as fulcrums, but since the openings 34a and 34b are formed in the recessed portions of the top plate portion 32, the distance from the fulcrum to the treatment portion is shortened. Therefore, the treatment instrument 7 can be operated more delicately.

  Furthermore, each of the openings 34a and 34b (opening holding members 33a and 33b) includes a flexible support portion 36 around the openings 34a and 34b (opening holding members 33a and 33b). Therefore, even if the treatment instrument 7 inserted into the one opening 34a is tilted as described above, the movement of the treatment instrument 7 inserted into the other opening 34b is less affected, and the treatment on the other side is performed. The device 7 is prevented from moving unexpectedly, and the treatment can be performed more smoothly.

  When taking out the retractor body 2 of the present embodiment, first, a release lever (not shown) under the belt 24 is pushed down. In this state, the belt 24 is pulled back with forceps or the like until it is completely detached from the second fixing member 23. Thereafter, the belt 24 is pulled up and the first fixing member 22 is removed.

<Second embodiment>
Next, a second embodiment of the present invention will be described.
In the following, the second embodiment will be described, but the difference from the first embodiment will be mainly described, and the description of the same matters will be omitted.

FIG. 6 is a cross-sectional view of a retractor according to a second embodiment of the present invention.
The second embodiment is the same as the first embodiment except that the configuration of the lid 3 is different.

  As shown in FIG. 6, in the present embodiment, the frame member 31 includes a proximal end side annular portion 37, a distal end side annular portion 38, and a cylindrical portion 39 that connects them. The inner diameter of the proximal end side annular portion 37 and the outer diameter of the distal end side annular portion 38 are substantially equal, and the inner periphery of the proximal end side annular portion 37 and the outer periphery of the distal end side annular portion 38 are connected via a cylindrical portion 39. It has a structured. The outer diameter of the front end side annular portion 38 is smaller than the inner diameter of the cylindrical member 21 and is a size that can be inserted into the cylindrical member 21.

  Further, in the present embodiment, the top plate portion 32 provided with two openings (first opening 34a and second opening 34b) has a flat plate shape, and a front end side annular portion 38 is formed around the top plate portion 32. . Therefore, when the lid 3 is mounted on the retractor main body 2, the openings 34 a and 34 b are located on the inner side of the end of the retractor main body 2. Therefore, the use of the treatment instrument 7 has the same effect as the first embodiment.

DESCRIPTION OF SYMBOLS 1 retractor 2 retractor main body 21 cylindrical member 22 1st fixing member 23 2nd fixing member 231 engaging recessed part 24 belt 3 lid body 31 frame member 311 engaging convex part 32 top plate part 33a first opening holding member 33b first Two-opening holding member 34a First opening 34b Second opening 35a First valve body 35b Second valve body 36 Support portion 37 Base end side ring portion 38 Front end side ring portion 39 Cylindrical portion 4 Retractor 5 Retractor body 51 Tube Shaped member 52 first fixing member 53 second fixing member 6 lid body 61 frame member 62 top plate portion 63a first opening 63b second opening 7, 7a, 7b treatment tool

Claims (7)

A lid that is detachably attached to a retractor body having a cylindrical shape,
The lid includes a top plate having at least one opening;
A frame member formed around the top plate portion and engaged with an end portion of the retractor body;
The said opening is located inside the edge part of the said retractor main body when the said cover body is mounted | worn with the said retractor main body, The cover body characterized by the above-mentioned.   The top plate has a portion that is recessed toward the inside of the retractor body when the lid is attached to the retractor body, and the opening is formed at the bottom of the recessed portion. The lid according to claim 1.   The said opening is a cover body of Claim 1 or 2 provided with the opening formation part which prevents the shape of the said opening from deform | transforming the circumference | surroundings.   The said top plate part is a cover body of Claim 3 which has the support part which supports the said opening formation part so that rocking | fluctuation is possible.   The lid according to claim 4, wherein the support portion is formed such that at least a part of the top plate portion has a bellows shape.   The said support part is a cover body of Claim 4 which comprises at least one part of the said top-plate part from the material softer than the said top-plate part.   A retractor comprising the lid according to any one of claims 1 to 6 and a retractor body.

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